From criticisms about their efforts to fight climate change to what they think of Trump, hear the philanthropists address criticisms of their work in their annual letter.

At the Gates Foundation, Melinda and Bill Gates command a $40 billion endowment aimed at improving health, and eradicating hunger and poverty in developing counties. To a lesser degree, the foundation also works to improve the U.S. educational system. On average, the organization doles out more than $4 billion in grants each year.

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Over the years, that sort of spending has raised questions from people both inside the sector and beyond. For the foundation’s annual letter this month, which is posted on GatesNotes, Bill’s personal blog, the power couple decided to answer 10 of the tougher ones they’ve encountered in recent years.

Their answers illuminate a unified theory about how, among the emerging class of mega-donors, the idea of giving while living can work best. (Both have pledged to give away the majority of their wealth within their lifetimes.)

But the goal is to show that while some of their efforts have failed, those big bets were worth taking as part of a learning curve to make worldwide progress. That’s happening: As the letter points out, the number of people living in extreme poverty has dropped by half over the last 20 years.

Here are the top 10 questions:

• Why don’t you give more to the United States?
• What do you have to show for the billions you’ve spent on U.S. education?
• Why don’t you give money to fight climate change?
• Are you imposing your values on other cultures?
• Does saving kids’ lives lead to overpopulation?
• How are President Trump’s policies affecting your work?
• Why do you work with corporations?
• Is it fair that you have so much influence?
• What happens when the two of you disagree?
• Why are you really giving away your money–what’s in it for you?

Some of those questions are worded in a way that’s intentionally biased–probably how they were first voiced.

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To be fair, the Gateses do give heavily in the U.S.; they put $500 million or so annually into education improvement initiatives and the U.S. Partnership on Mobility from Poverty. But they argue that each dollar goes further in the developing world. “We don’t compare different people’s suffering. All suffering is a terrible tragedy,” says Melinda. “We do, however, assess our ability to help prevent different kinds of suffering. When we studied the global health landscape, we realized that our resources could have a disproportionate impact. We knew we could help save literally millions of lives. So that’s what we’ve tried to do.”

The group has spent over $15 billion on vaccines since its inception, she adds, a main reason why the worldwide childhood morbidity rate has been cut in half since 2000. In the U.S. many of the easy fixes like this are already available, which has lead to work on more complex issues that money alone can’t solve.

The query about climate change hinges on something of a technicality. The couple also battles climate change, but often with their own personal fortunes. Bill, for instance, is a part of Breakthrough Energy Ventures, a $1 billion-plus investment fund seeking to back companies in areas like grid-scale storage and geothermal power. On the foundation side, there’s a need to ensure that each investment yields a real gain, so the couple has looked at so-called “climate smart-crops” that are more adaptable to the sort of crazy weather, pest, and diseases that will arise alongside global warming. That’s not directly battling global warming so much as ensuring that they control some unavoidable fallout from environmental change so they don’t have to start over as the climate changes.

When it comes to working with corporations, they say, the foundation’s cash advantage provides serious leverage: If you have the means, you can incentivize great scientific, technological, or medical breakthroughs by reducing R&D costs. That buying power gets flexed with an agreement that protects the resulting intellectual property so it’s accessible to those who might not otherwise be able to afford it. “Every partner we work with is required to make products developed with foundation funding widely available at an affordable price,” says Melinda.

Perhaps the most contentious answer, however, focuses impact of President Trump on the foundation’s work. “President Trump proposed severe cuts to foreign aid,” Bill writes. “To its credit, Congress has moved to put the money back in the budget. It’s better for the United States when it leads, through both hard power and soft power.”

There’s an emotional and economic argument to why this remains important. “These efforts save lives. They also create U.S. jobs. And they make Americans more secure by making poor countries more stable and stopping disease outbreaks before they become pandemics,” Bill says. “The world is not a safer place when more people are sick or hungry.”

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About the author

Ben Paynter is a senior writer at Fast Company covering social impact, the future of philanthropy, and innovative food companies. His work has appeared in Wired, Bloomberg Businessweek, and the New York Times, among other places.